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<br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br />Whitewater Bldg Mtrl <br />M-77-129- <br />WHITEWATER PIT 500 <br />09/22/85 <br />~f1~ <br />112 Ernclosure <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />V Annual Report ~E~~.;r~~ <br />Map SEP i ~ '1995 <br />MINED LAND <br />RECLAMATION DIVISION <br />Remarks: <br />v Myna wrc <br />